CLIA lab
CLIA 39D2151016: Blue MTN Pediatrics
Brodheadsville, PA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 39D2151016 belongs to Blue MTN Pediatrics in Brodheadsville, PA.
Certificate of Waiver, effective July 10, 2026, expires July 9, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 10, 2026
- Certificate expiration
- July 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 10, 2018
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 39D2151016
- Lab name
- Blue MTN Pediatrics
- Address
- 1612 Rte 209, Brodheadsville, PA 18322
- Phone
- (570) 402-8900
- Fax
- (570) 402-8122
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Brodheadsville, PA
- Brodheadsville Family PracticeCertificate of Waiver, Physician office39D0191663
- Frank G Romascavage DOCertificate of Waiver, Physician office39D0937482
- Jeffexpress West EndCertificate of Waiver, Other39D2179616
- Lvpg Family Medicine - West EndCertificate of Waiver, Physician office39D1016761
- Lvpg Ob/Gyn West EndCertificate of Waiver, Physician office39D1075794
- Pocono Community PharmacyCertificate of Waiver, Pharmacy39D2235765
- ST Luke's Care Now BrodheadsvilleCertificate of Waiver, Other39D2141138
- ST Lukes Cardiology AssociatesCertificate of Waiver, Physician office39D0996615
- Vhp-Pediatrics West EndCertificate of Waiver, Physician office39D2177898
Related
Questions
What is the CLIA number for Blue MTN Pediatrics in Brodheadsville?
39D2151016, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Blue MTN Pediatrics hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 39D2151016 expire?
The CMS file lists July 9, 2028 as the certificate expiration date; the certificate took effect July 10, 2026.